Ambulance Billing Services - Medical Transportation Billing Services

Enhanced Management Services® continually accepts resumes for all positions. If you have previous medical billing experience, please fill out the online employment questionnaire and attach a resume for further consideration.

Position Information

Postion Desired
Date Available to Work

How did you hear
about this position?

Personal Information

First Name MI: Last: Email:

Address 1
Address 2
City
State
Zip
Home Phone
Cell Phone

Have you ever been excluded or are you currently excluded from participating in any federal health care program such as Medicare or Medicaid?

Yes No

If yes, please explain:

Education and Training

	Name	Major	Date Completed	Degree Obtained
High School
College
Other
Other

Related Employment Experience

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Other Employment

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Employer
Address
Phone
Fax
Briefly Describe Your Duties
Supervisor
Supervisor Email
Wages	Starting $ /year	Ending $ /year
Employed Dates	From	To
Reason for Leaving
What Value Did You Add to This Company or its Customers/Clients?

Personal References

Name
Address
Phone Number

Name
Address
Phone Number

Name
Address
Phone Number

Business/Employment References

Name
Address
Phone Number

Name
Address
Phone Number

Name
Address
Phone Number

Career Information

Salary Requirements

Describe Your Career Objectives

If You Were Hired, What Value Would You Add to Our Company?

Do You Have Any Friends or Relatives Employed By Us?

Yes No

If yes, please provide names and their relationships to you:

Agreement to Terms

Yes No	I Certify that all information is correct and my application is true and correct. I shall provide Enhanced Management Services, Inc.® if there is any change in the information provided.
	I understand that any false or incomplete information may be grounds for dismissal from employment at Enhanced Management Services, Inc.®
	I authorize Enhanced Management Services, Inc.® to obtain and review such documents from other services and third parties.
	I authorize third parties to provide such information and documents to Enhanced Management Services, Inc.®, to assist Enhanced Management Services, Inc.® in evaluating my professional competence and qualifications, including my character and ethical standards, my ability to work cooperatively with others, and my physical and mental health, and my emotional stability.
	I release Enhanced Management Services, Inc.®, its officers, employees and agents from any and all liability in conducting such an investigation.
	I release all individuals, corporations, and organizations from any and all liability who provide information, including otherwise privileged or confidential information relating to this application.

Enhanced Management Services, Inc.® considers applications for employment without regard to race, color, religion, sex, national origin, age (over 40), disability, veteran status, or any other characteristic protected by law.

By submitting this preliminary questionnaire for employment, I certify that the answers I have given are true and correct and that I understand that any misrepresentation or omission of facts on my part will be justification for rejection of my consideration for employment, or termination of my employment with Enhanced Management Services, Inc.® if I am ultimately hired. I understand that this questionnaire does not take the place of a formal application for employment which I may also be expected to complete.